Kerala Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2022  |  Volume : 34  |  Issue : 1  |  Page : 88-

Continuing the service despite the pandemic: Ocular surgery on a COVID-19 patient


Karthikeyan Mahalingam, Somya Kumari, Monika Arora, Ramanjit Sihota 
 Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Karthikeyan Mahalingam
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari nagar, New Delhi
India




How to cite this article:
Mahalingam K, Kumari S, Arora M, Sihota R. Continuing the service despite the pandemic: Ocular surgery on a COVID-19 patient.Kerala J Ophthalmol 2022;34:88-88


How to cite this URL:
Mahalingam K, Kumari S, Arora M, Sihota R. Continuing the service despite the pandemic: Ocular surgery on a COVID-19 patient. Kerala J Ophthalmol [serial online] 2022 [cited 2022 Jun 28 ];34:88-88
Available from: http://www.kjophthal.com/text.asp?2022/34/1/88/343663


Full Text



Dear Editor,

The first case of novel coronavirus (COVID-19) outbreak in India was reported on January 30, 2020.[1] To date (5.2.22), 3.51 crore people were affected in India. Elective medical care services were shut down with a lot of uncertainty.[2] Ocular surgery on a COVID-19 patient was deferred by two weeks unless there was a risk for potential loss of vision, eye, or life.[3] Ocular injuries if not treated early can lead to sight-threatening complications.[4] This is the report of ocular surgery in COVID patients.

A 5-year-old child presented with left eye subconjunctival foreign body following trauma with a pencil. A globe exploration and foreign body removal under general anesthesia was planned. Although the patient was asymptomatic for COVID-19, due to the ongoing pandemic, a severe acute respiratory syndrome coronavirus-2 test was done before surgery.[5] The patient turned positive and surgery was planned in an operation theater designated for COVID patients. After donning level three personal protective equipment (PPE), the outer glove was sterilized with alcohol-based disinfectant, and a sterile gown and sterile gloves were donned.

There was poor control on the microscope's foot pedal because of shoes and PPE; hence, the hand control was used for magnification and focus. Fogging reduced visibility, making the surgery challenging. After conjunctival peritomy, the foreign body (pencil lead) was removed; ensuring that the sclera was intact, the conjunctiva was closed. The conjunctival wound was healthy at 10-day follow-up and the patient was asymptomatic for COVID-19.

Sealing the N95 mask (to prevent air leak to goggles), use of goggles with vent, and cleaning the goggles with the antifog solution could reduce fogging. Prevention of fogging and enhance visibility for good surgical results is imperative for more complicated COVID-positive cases which are likely to present to an ophthalmologist.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Cheke RS, Shinde S, Ambhore J, Adhao V, Cheke D. Coronavirus: Hotspot on coronavirus disease 2019 in India. Indian J Med Sci 2020;72:29-34.
2Reddy JC, Vaddavalli PK, Sharma N, Sachdev MS, Rajashekar YL, Sinha R, et al. A new normal with cataract surgery during COVID-19 pandemic. Indian J Ophthalmol 2020;68:1269-76.
3Sengupta S, Honavar SG, Sachdev MS, Sharma N, Kumar A, Ram J, et al. All India Ophthalmological Society – Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic. Indian J Ophthalmol 2020;68:711-24.
4Lecuona K. Assessing and managing eye injuries. Community Eye Health 2005;18:101-4.
5Al-Muharraqi MA. Testing recommendation for COVID-19 (SARS-CoV-2) in patients planned for surgery – Continuing the service and 'suppressing' the pandemic. Br J Oral Maxillofac Surg 2020;58:503-5.